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F Clavel-Chapelon

Publications and source records attributed to F Clavel-Chapelon.

At least 55 records · Page 3Linked to original sources
PubMed2002

Consumption of dairy products in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: data from 35 955 24-hour dietary recalls in 10 European countries.

OBJECTIVES: To describe and compare the consumption of dairy products in cohorts included in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Data from single 24-hour dietary recall interviews collected through a highly standardised computer-based program (EPIC-SOFT) in 27 redefined centres in 10 European countries between 1995 and 2000. From a total random sample of 36 900, 22 924 women and 13 031 men were selected after exclusion of subjects under 35 and over 74 years of age. RESULTS: A high total consumption of dairy products was reported in most of the centres in Spain and in the UK cohort sampled from the general population, as well as in the Dutch, Swedish and Danish centres. A somewhat low consumption was reported in the Greek centre and in some of the Italian centres (Ragusa and Turin). In all centres and for both sexes, milk constituted the dairy sub-group with the largest proportion (in grams) of total dairy consumption, followed by yoghurt and other fermented milk products, and cheese. Still, there was a wide range in the contributions of the different dairy sub-groups between centres. The Spanish and Nordic centres generally reported a high consumption of milk, the Swedish and Dutch centres reported a high consumption of yoghurt and other fermented milk products, whereas the highest consumption of cheese was reported in the French centres. CONCLUSION: The results demonstrate both quantitative and qualitative disparities in dairy product consumption among the EPIC centres. This offers a sound starting point for analyses of associations between dairy intake and chronic diseases such as cancer.

Adult↗
PubMed2002

Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study.

OBJECTIVE: To describe and compare the consumption of total fish (marine foods) and the fish sub-groups - white fish, fatty fish, very fatty fish, fish products and crustacea, in participants from the European Investigation into Cancer and Nutrition (EPIC) study. DESIGN: Cross-sectional analysis of dietary intake using a computerised standardised 24-hour recall interview. Crude means, means and standard errors adjusted by age, season and day of the week were calculated, stratified by centre and gender. SETTING: Twenty-seven redefined centres in the 10 European countries participating in the EPIC study. SUBJECTS: In total, 35 955 subjects (13 031 men and 22 924 women), aged 35-74 years, selected from the main EPIC cohort. RESULTS: A six- to sevenfold variation in total fish consumption exists in women and men, between the lowest consumption in Germany and the highest in Spain. Overall, white fish represented 49% and 45% of the intake of total fish in women and men, respectively, with the greatest consumption in centres in Spain and Greece and the least in the German and Dutch centres. Consumption of fatty fish reflected that of total fish. However, the greatest intake of very fatty fish was in the coastal areas of northern Europe (Denmark, Sweden and Norway) and in Germany. Consumption of fish products was greater in northern than in southern Europe, with white fish products predominating in centres in France, Italy, Spain, The Netherlands and Norway. Intake of roe and roe products was low. The highest consumption of crustacea was found in the French, Spanish and Italian centres. The number of fish types consumed was greater in southern than in northern Europe. The greatest variability in consumption by day of the week was found in the countries with the lowest fish intake. CONCLUSIONS: Throughout Europe, substantial geographic variation exists in total fish intake, fish sub-groups and the number of types consumed. Day-to-day variability in consumption is also high.

Adult↗
PubMed2002

Patterns of alcohol consumption in 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) project.

OBJECTIVE: The aim of this study was to compare the quantities of alcohol and types of alcoholic beverages consumed, and the timing of consumption, in centres participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). These centres, in 10 European countries, are characterised by widely differing drinking habits and frequencies of alcohol-related diseases. METHODS: We collected a single standardised 24-hour dietary recall per subject from a random sample of the EPIC cohort (36 900 persons initially and 35 955 after exclusion of subjects under 35 and over 74 years of age). This provided detailed information on the distribution of alcohol consumption during the day in relation to main meals, and was used to determine weekly consumption patterns. The crude and adjusted (by age, day of week and season) means of total ethanol consumption and consumption according to type of beverage were stratified by centre and sex. RESULTS: Sex was a strong determinant of drinking patterns in all 10 countries. The highest total alcohol consumption was observed in the Spanish centres (San Sebastian, 41.4 g day-1) for men and in Danish centres (Copenhagen, 20.9 g day-1) for women. The lowest total alcohol intake was in the Swedish centres (Umeå, 10.2 g day-1) in men and in Greek women (3.4 g day-1). Among men, the main contributor to total alcohol intake was wine in Mediterranean countries and beer in the Dutch, German, Swedish and Danish centres. In most centres, the main source of alcohol for women was wine except for Murcia (Spain), where it was beer. Alcohol consumption, particularly by women, increased markedly during the weekend in nearly all centres. The German, Dutch, UK (general population) and Danish centres were characterised by the highest percentages of alcohol consumption outside mealtimes. CONCLUSIONS: The large variation in drinking patterns among the EPIC centres provides an opportunity to better understand the relationship between alcohol and alcohol-related diseases.

Adult↗
PubMed2002

Trends in self-reported past alcoholic beverage consumption and ethanol intake from 1950 to 1995 observed in eight European countries participating in the European Investigation into Cancer and Nutrition (EPIC).

OBJECTIVE: To describe the trends of self-reported past consumption of alcoholic beverages and ethanol intake from 1950 to 1995 within the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: Data on consumption of beer/cider, wine and liqueur/spirits were obtained retrospectively at age 20, 30 and 40 years to calculate average consumption and ethanol intake for the time periods 1950-1975 (at age 20), 1960-1985 (at age 30) and 1970-1995 (at age 40). Regression analysis was conducted with the time period data to assess trends in past alcoholic beverage consumption and ethanol intake with time. SETTING: The EPIC project. SUBJECTS: In total, 392 064 EPIC participants (275 249 women and 116 815 men) from 21 study centres in eight European countries. RESULTS: Generally, increases in beer/cider consumption were observed for most EPIC centres for 1950-1975, 1960-1985 and 1970-1995. Trends in wine consumption differed according to geographical location: downward trends with time were observed for men in southern European EPIC centres, upward trends for those in middle/northern European study centres. For women, similar but less pronounced trends were observed. Because wine consumption was the major contributor to ethanol intake for both men and women in most study centres, time trends for ethanol intake showed a similar geographical pattern to that of wine consumption. CONCLUSION: The different trends in alcoholic beverage consumption and ethanol intake suggest that information depicting lifetime history of ethanol intake should be included in analyses of the relationship between ethanol and chronic diseases, particularly in multi-centre studies such as EPIC.

Adult↗
PubMed2002

Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project.

OBJECTIVE: To describe the diversity in dietary patterns existing across centres/regions participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN AND SETTING: Single 24-hour dietary recall measurements were obtained by means of standardised face-to-face interviews using the EPIC-SOFT software. These have been used to present a graphic multi-dimensional comparison of the adjusted mean consumption of 22 food groups. SUBJECTS: In total, 35 955 men and women, aged 35-74 years, participating in the EPIC nested calibration study. RESULTS: Although wide differences were observed across centres, the countries participating in EPIC are characterised by specific dietary patterns. Overall, Italy and Greece have a dietary pattern characterised by plant foods (except potatoes) and a lower consumption of animal and processed foods, compared with the other EPIC countries. France and particularly Spain have more heterogeneous dietary patterns, with a relatively high consumption of both plant foods and animal products. Apart from characteristics specific to vegetarian groups, the UK 'health-conscious' group shares with the UK general population a relatively high consumption of tea, sauces, cakes, soft drinks (women), margarine and butter. In contrast, the diet in the Nordic countries, The Netherlands, Germany and the UK general population is relatively high in potatoes and animal, processed and sweetened/refined foods, with proportions varying across countries/centres. In these countries, consumption of vegetables and fruit is similar to, or below, the overall EPIC means, and is low for legumes and vegetable oils. Overall, dietary patterns were similar for men and women, although there were large gender differences for certain food groups. CONCLUSIONS: There are considerable differences in food group consumption and dietary patterns among the EPIC study populations. This large heterogeneity should be an advantage when investigating the relationship between diet and cancer and formulating new aetiological hypotheses related to dietary patterns and disease.

Adult↗
PubMed2002

Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC).

OBJECTIVE: To evaluate under- and overreporting and their determinants in the EPIC 24-hour diet recall (24-HDR) measurements collected in the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: Cross-sectional analysis. 24-HDR measurements were obtained by means of a standardised computerised interview program (EPIC-SOFT). The ratio of reported energy intake (EI) to estimated basal metabolic rate (BMR) was used to ascertain the magnitude, impact and determinants of misreporting. Goldberg's cut-off points were used to identify participants with physiologically extreme low or high energy intake. At the aggregate level the value of 1.55 for physical activity level (PAL) was chosen as reference. At the individual level we used multivariate statistical techniques to identify factors that could explain EI/BMR variability. Analyses were performed by adjusting for weight, height, age at recall, special diet, smoking status, day of recall (weekday vs. weekend day) and physical activity. SETTING: Twenty-seven redefined centres in the 10 countries participating in the EPIC project. SUBJECTS: In total, 35 955 men and women, aged 35-74 years, participating in the nested EPIC calibration sub-studies. RESULTS: While overreporting has only a minor impact, the percentage of subjects identified as extreme underreporters was 13.8% and 10.3% in women and men, respectively. Mean EI/BMR values in men and women were 1.44 and 1.36 including all subjects, and 1.50 and 1.44 after exclusion of misreporters. After exclusion of misreporters, adjusted EI/BMR means were consistently less than 10% different from the expected value of 1.55 for PAL (except for women in Greece and in the UK), with overall differences equal to 4.0% and 7.4% for men and women, respectively. We modelled the probability of being an underreporter in association with several individual characteristics. After adjustment for age, height, special diet, smoking status, day of recall and physical activity at work, logistic regression analyses resulted in an odds ratio (OR) of being an underreporter for the highest vs. the lowest quartile of body mass index (BMI) of 3.52 (95% confidence interval (CI) 2.91-4.26) in men and 4.80 (95% CI 4.11-5.61) in women, indicating that overweight subjects are significantly more likely to underestimate energy intake than subjects in the bottom BMI category. Older people were less likely to underestimate energy intake: ORs were 0.58 (95% CI 0.45-0.77) and 0.74 (95% CI 0.63-0.88) for age (> or =65 years vs. <50 years). Special diet and day of the week showed strong effects. CONCLUSION: EI tends to be underestimated in the vast majority of the EPIC centres, although to varying degrees; at the aggregate level most centres were below the expected reference value of 1.55. Underreporting seems to be more prevalent among women than men in the EPIC calibration sample. The hypothesis that BMI (or weight) and age are causally related to underreporting seems to be confirmed in the present work. This introduces further complexity in the within-group (centre or country) and between-group calibration of dietary questionnaire measurements to deattenuate the diet-disease relationship.

Adult↗
PubMed2002

Evolution of age at menarche and at onset of regular cycling in a large cohort of French women.

BACKGROUND: Early exposure to ovarian hormones is considered to increase breast cancer incidence. The age at which the ovaries become functional is thus important. METHODS: We explored the evolution of age at first menstruation and at onset of regular cycling in 86 031 women participating in the E3N-EPIC cohort study, part of the European Prospective Investigation into Cancer. RESULTS: We observed an increase in mean age at menarche among women born between 1925 and 1930, followed by a steady decrease in the youngest birth cohorts. In contrast, age at onset of regular cycling increased gradually from 1925 onwards. There was thus a steady increase in the interval between age at menarche and at onset of regular cycling, mainly due to an increase in the percentage of women in whom regular cycling started at least 5 years after menarche (from 9.0% among women born in 1925-1929 to 20.8% in those born in 1945-1950). The increase in the interval between menarche and onset of regular cycling was even greater among women with a late menarche. CONCLUSIONS: This increase might be due to a change in dietary intake and/or physical exercise aimed at achieving the slim silhouette desired by the younger generations.

Adult↗
PubMed2001

Do eating habits differ according to alcohol consumption? Results of a study of the French cohort of the European Prospective Investigation into Cancer and Nutrition (E3N-EPIC).

BACKGROUND: The potential of dietary habits to confound the association between alcohol consumption and health needs further study. OBJECTIVE: We examined whether eating habits differed according to alcohol consumption in a large cohort of French women. DESIGN: This was a cross-sectional study of the French cohort of the European Prospective Investigation into Cancer and Nutrition (E3N-EPIC). The cohort was established in 1990 and includes 100000 women born between 1925 and 1950. Dietary data were obtained between 1993 and 1995 by using self-administered food-frequency questionnaires. About 73000 questionnaires were analyzed, and women were placed into 7 categories of alcohol consumption. RESULTS: After adjustment for energy derived from alcohol, increasing alcohol consumption was associated with a higher total energy intake, a higher percentage of energy intake as protein and lipids, and higher intakes of cholesterol, fatty acids, retinol, iron, and vitamin E. Conversely, energy provided by carbohydrates decreased with increasing alcohol consumption, as did beta-carotene intake. Increasing alcohol consumption was associated with higher consumption of animal products, cheese, potatoes, oil, bread, and breakfast cereals and with lower consumption of vegetables and dairy products. CONCLUSION: In this population of middle-aged, highly educated French women, marked differences in dietary patterns and nutrient intakes were found according to alcohol consumption. Part of the detrimental effect of alcohol on health may be due to the less healthy dietary habits of drinkers. This points to a confounding role of eating habits and nutrient intakes in the relation between alcohol and health.

Adult↗
PubMed2001

[Fat consumption and breast cancer: preliminary results from the E3N-Epic cohort].

Recent reviews have concluded that a high consumption of total, saturated or animal, fat could possibly increase the risk of breast cancer. However these results are highly dependent on the type of study; indeed, most of the prospective studies do not support this association. In this paper, we investigated the relationship between fat consumption and breast cancer risk in the E3N-Epic cohort, the French component of the European Prospective Investigation into Cancer and Nutrition. Assessment of fat consumption was based on daily intakes of food items and nutrients using a food-frequency questionnaire. Relative risk (RR) estimates were calculated using Cox's proportional hazards model. After an average of 3.4 years of follow-up, 838 cases of incident breast cancer were recorded in a study population of 65,879 women. The mean caloric intake was 2,073 kcal (SD 540), with 37% of calories coming from fat intake. Milk products and vegetable oils were the main sources of fat in the diet. We found a small positive association between fat intake and breast cancer risk. Compared with the lowest, women in the highest quartile of fat intake had a 37% higher risk of breast cancer (RR 1.37, CI95% = 0.99-1.89). There was no detectable association between fatty acids or food items contributing to fat intake and breast cancer risk. These analyses suggest there is a need for longer follow-up time to increase statistical power and confirm these tendencies.

Adult↗
PubMed2000

[Hormone replacement therapy in menopause and risk of breast cancer].

OBJECTIVES: Many epidemiological studies have analysed the relation between hormonal replacement therapy and risk of breast cancer. We present here a synthesis of the available results. MATERIAL AND METHODS: In 1997, a meta-analysis synthesised 90% of the data available at the time, obtained from 15 cohort and 36 case-control studies. This meta-analysis collected 53,000 breast cancers, 22% of these breast cancers having been observed in cohort studies. Since the publication of this meta-analysis, six studies totalling 8,000 cases (32% from cohort studies) have been published: two of these studies were partially included in the meta-analysis and the other four provided entirely new data. RESULTS: The conclusion, based on the available evidence, is that the risk of breast cancer diagnosis is higher among women who have used hormonal replacement therapy than among women who have not. The risk increases with treatment duration, is reduced when treatment is stopped and disappears almost completely a few years (5 in the meta-analysis) after the end of the treatment. The increase in the risk of breast cancer may be larger with estrogen-progestogen therapy than with estrogen alone. What are the consequences in terms of public health? From the results of the meta-analysis, one can estimate that the use of replacement therapy for 10 years between age 50 and 60 by 1,000 women will lead to the diagnosis of 6 extra breast cancers. This corresponds to the observation of 69 cases per 1,000 treated women after 20 years follow-up, as compared to the 63 cases expected among 1,000 untreated women. DISCUSSION: These results require confirmation. The observed increase in the risk of breast cancer is open to biases, particularly to a screening bias if women receiving hormonal replacement therapy have a more intensive surveillance than other women. Overall, the total number of women, across studies, who have received estrogen-progestogen therapy is small and their treatment was usually a combination of natural estrogens and medroxy progesterone acetate; therefore, the long term consequences of the treatments commonly used in France (synthetic estrogens and a variety of progestogens) have not been evaluated, this evaluation is much needed. CONCLUSION: What is needed is a global view of the risks and benefits of hormonal replacement therapy, and more epidemiologic data are required to reach this goal. In the present state of knowledge, the moderate excess risk of breast cancer observed does not justify a change in medical practice, neither in the selection of women to whom hormonal replacement therapy should be offered nor in the duration of their treatment.

Adult↗
PubMed1999

Surveillance behavior of women with a reported family history of colorectal cancer.

STUDY OBJECTIVE: The present study tested whether the surveillance behavior of women with a family history of colorectal cancer (CRC) differed from that of women without such a history. DESIGN: The study included 72,710 subjects from the population of E3N, a cohort study, part of the European Prospective Investigation on Cancer, investigating risk factors for cancer among women. RESULTS: Fecal occult-blood testing (FOBT) was reported by 19.4% of the women with no CRC in their family and by 21.8% of those with one or more CRC (frequency odds ratio (FOR) = 1.01; ns). The degree of kinship did not influence FOBT. Colonoscopy was reported by 10.9% of women with no CRC in their family; its frequency increased with increasing number of subjects affected by CRC in the family, in particular when it concerned first-degree relatives. Colonoscopy was reported almost four times more frequently by subjects having two or more first-degree relatives with CRC (FOR = 3.55; 95% CI 2.47-5.10) than by those without any affected member; the frequency of colonoscopy increased, though less sharply, among women with second-degree affected relatives, compared with those without any affected relative in their family. CONCLUSION: In conclusion, whereas FOBT was unaffected by family history of CRC, screening colonoscopy was more frequent among women with a reported family history and differed with the degree of kinship of the affected relatives. The high rate of colonoscopy observed among subjects with first- and second-degree relatives is likely due to physician participation in screening decisions.

Adult↗
PubMed1999

[Dealing with missing, abnormal and incoherent data in E3N cohort study].

BACKGROUND: The E3N Study, 'Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale', is a cohort study, aiming at studying cancer risk factors on 100,000 women. Even if the incidence of problematic (missing, incoherent, etc.) data is low, any multivariate analysis which would be based only on complete subjects would rely on a too small sample, which would not necessarily be representative of the studied population. Results could thus be biased. METHODS: Our dealing with problematic data includes RESULTS: We looked at the number of individuals on which an analysis on 19 variables could be undertaken. The management of missing data made exploitable one fourth of the cohort, i.e.74.6% of individuals instead of 50.5%. Moreover, for 89.0% of subjects, one variable at most (out of the 19 studied) has missing datum. CONCLUSIONS: The main difficulty does not stand so much in the choice and implementation of methods to deal with problematic data than in the identification of their process of existence. Most of what was gained was due to the simplest methods: cold-deck and deductive method.

Cohort Studies↗
PubMed1998

A validation study on status and age of natural menopause reported in the E3N cohort.

The accuracy of self-reported menopausal status and age at menopause has been analysed in a validation study using the gynecologist's medical records as the reference. Concordance between the two sources for menopausal status was assessed in 151 women. The kappa coefficient obtained was 0.85 (95% CI, 0.69-1.00). Agreement on age at menopause was tested in 57 women and the kappa coefficient obtained was 0.64 (95% CI, 0.34-0.94). Age at menopause was accurately reported by 32% of the subjects. This percentage increased to 69 and 86% when agreement within 1 and 2 year(s) was considered, respectively. These results suggest that women can provide data on their natural menopause history with sufficient accuracy to test some hypotheses associating this event with the evolution of their health status.

Adult↗
PubMed1997

E3N, a French cohort study on cancer risk factors. E3N Group. Etude Epidémiologique auprès de femmes de l'Education Nationale.

This paper describes the design of E3N, a prospective cohort study conducted in France on risk factors for female cancers. The cohort comprises 100,000 women, aged 40-65 years at baseline in 1990. Participants were asked to complete questionnaires every 18 months. The main hypotheses studied concern the relationship between diet and cancer and between hormonal treatments and cancer. All cancers diagnosed are registered, together with other diseases (cardiovascular diseases, diabetes, osteoporosis). The study population and the follow-up procedure are described.

Adult↗
PubMed1997

Diet and breast cancer: review of the epidemiologic literature.

The relationship between diet and breast cancer has been analyzed by animal, ecologic, migrant, and epidemiologic studies. The 14 cohort and 33 case-control studies that have been published to date are reviewed in this article. Factors considered in these studies include caloric intake, as well as fat, protein, fiber, beta-carotene, and vitamin E and C consumption. The results of the published studies are summarized, and the point estimates of the risks corresponding to the highest category of consumption as compared to the lowest are presented in figures. Some of the disagreements among studies could be explained by the methodologic difficulties inherent in dietary investigations, such as the establishment of an accurate dietary history, or insufficient diversity in exposure. Further studies taking these points into account and minimizing biases inherent to a case-control design might help to elucidate the relationship between diet and breast cancer, and to define dietary recommendations. Only large long-term cohort studies such as are now in progress can help to resolve the still unanswered questions concerning the contribution of these dietary factors to the risk of breast cancer. We suggest the establishment of new dietary cohorts and the continued follow-up of the existing cohorts.

Breast Neoplasms↗
PubMed1996

[E3N, a cohort study on cancer risk factors in MGEN women. Description of protocol, main characteristics and population].

This paper describes the design of E3N, a prospective cohort study on risk factors for female cancers, conducted in France. The cohort includes 100,000 women, aged 40 to 65 years at baseline in 1990. Participants were asked to complete questionnaires every 18 months. The main hypotheses studied concern the relationships between diet and cancer and between hormonal treatments and cancer. All cancer sites are registered together with other diseases (cardiovascular diseases, diabetes, osteoporosis). The follow-up procedure and the study population are described.

Adult↗